MEDICARE: MS. BILLIE MARLENE OLSEN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW7383	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093924649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BILLIE MARLENE OLSEN LCSW

Provider Business Mailing Address
First Line	:	1632 GUNSMITH DR
Second Line	:
City	:	LUTZ
State	:	FL
Zip	:	33559-3303
Country	:	US
Telephone Number	:	813-957-3244
Fax Number	:	813-872-1530

Provider Business Practice Location Address
First Line	:	7823 N DALE MABRY HWY STE 104
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-3273
Country	:	US
Telephone Number	:	813-957-3244
Fax Number	:	813-315-6877

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	09/01/2021

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